Feehally J, Beattie T J, Brenchley P E, Coupes B M, Houston I B, Mallick N P, Postlethwaite R J
N Engl J Med. 1984 Feb 16;310(7):415-20. doi: 10.1056/NEJM198402163100702.
Cyclophosphamide is widely used to induce a remission of minimal-change nephropathy, but concerns have been raised about whether its effects on cellular immunity persist after treatment is discontinued. We studied functional and numerical measures of cellular immunity in children who had minimal-change nephropathy with frequent steroid-responsive relapses and were receiving cyclophosphamide (2.5 mg per kilogram of body weight per day for eight weeks). Sequential studies during such treatment showed that cyclophosphamide caused lymphopenia, particularly among T helper cells, resulting in a significant fall in the immunoregulatory (helper/suppressor) cell ratio. This change persisted 1 to 3 months after cyclophosphamide was discontinued, but measures of immune function reverted to normal after 6 to 12 months. Children with minimal-change nephropathy in long-term remission had no difference in T-cell subpopulations, lymphocyte responses to mitogens, or suppressor-cell function that could be attributed to the disease itself or to the previous use of cyclophosphamide.
环磷酰胺被广泛用于诱导微小病变性肾病的缓解，但对于停药后其对细胞免疫的影响是否持续存在，人们已提出了担忧。我们研究了患有微小病变性肾病且频繁出现激素反应性复发并正在接受环磷酰胺治疗（每天每千克体重2.5毫克，共八周）的儿童的细胞免疫功能和数量指标。在这种治疗期间的系列研究表明，环磷酰胺导致淋巴细胞减少，尤其是在辅助性T细胞中，导致免疫调节（辅助/抑制）细胞比例显著下降。这种变化在停用环磷酰胺后持续1至3个月，但免疫功能指标在6至12个月后恢复正常。长期缓解的微小病变性肾病患儿在T细胞亚群、淋巴细胞对有丝分裂原的反应或抑制细胞功能方面没有差异，这些差异不能归因于疾病本身或先前使用环磷酰胺。
